The Softer Side of Practicing Medicine

By Jonelle Todd
Wednesday, March 11, 2020
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A growing body of research shows clinicians with a high level of emotional intelligence not only provide a benefit to their patients, they also help protect themselves from the stresses of the medical profession.

Emotional intelligence (EI) is the ability to recognize and empathize with the emotions of others, and to use that awareness to communicate, resolve conflicts and manage relationships effectively. In general, people with high EI have a tendency to be more resilient, are better able to cope with stress and manage relationships with others more effectively.

A compilation of evidence suggests that EI is more than a desirable but ultimately nonessential quality in physicians; rather, EI skills appear to have a direct impact on patient outcomes. These skills also help increase physician well-being and protect against burnout. And despite popular misconceptions, EI skills can be learned.

Teaching Emotional Intelligence

A study by Loyola University Medical Center researchers Ramzan Shahid, MD, Jerold Stirling, MD, and William Adams, MA, published in Advances in Medical Education and Practice, examined the effects of EI training when integrated into the educational curriculum for resident physicians.

The residents participating in the Loyola study completed the Bar-On Emotional Quotient Inventory 2.0 survey, a 133-item EI assessment, before and after receiving EI training. Educational interventions included classroom instruction, videos and workshops focused on self-awareness of emotions, the ability to manage emotional reactions, ability to pick up on the emotions of others and social skills. After completing the training, student scores for overall EI and stress management skills increased significantly.

Buffering Against Burnout

The Loyola study also aimed to determine whether educational intervention would increase the overall EI levels — specifically, stress management and wellness scores — among residents. The researchers concluded that as a group, the residents experienced a significant increase in total EI scores, leading the researchers to theorize that teaching EI skills may improve stress management skills, promote wellness and prevent burnout in resident physicians.

The value of EI education in preventing burnout also extends to healthcare organization leaders. In the article “Targeting Physician Burnout Through Emotional Intelligence, Self-Care Techniques, and Leadership Skills Training: A Qualitative Study,” published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes, researchers reported that leadership training in EI and self-care can help combat professional burnout on both institutional and individual levels.

The qualitative research study evaluated the sustainable effects of a coaching workshop for healthcare program directors that focused on an awareness, acknowledgement and action approach. Participants completed the MHS3 Emotional Quotient Inventory and the Maslach Burnout Inventory before the workshop, and filled out a follow-up questionnaire nine months later.

During the workshop, participants learned coaching techniques focused on improving self-awareness, self-care, self-compassion and boundary-setting. Introducing workshop participants to EI concepts and how the skills can be used to enhance EI and wellness in others led to changes in attitudes and behaviors among the directors regarding a perceived ability to guide, train and lead others. The researchers found that increasing leadership awareness of burnout factors and introducing them to practical applications to address it helped workshop participants experience subjectively effective and sustainable improvements in physician EI and wellness over the nine-month follow-up period.

Soothing Patient Suffering

In an essay published in the Journal of the American Medical Association, University of Rochester professor Ronald M. Epstein, MD, and University of Washington oncologist Anthony L. Back, MD, coauthored an essay commenting on their findings following a review of literature on how physicians address patient suffering. The authors wrote that though suffering is pervasive in the medical profession, they found few articles on the subject in medical literature, and almost none directed at practicing clinicians.

The authors asserted that physicians could have a pivotal role in alleviating suffering if they change how they respond to patients, yet professional training in this area is sorely lacking. Drs. Epstein and Back suggest that physicians can better address patient suffering by adopting two clinical approaches known as “turning toward” and “refocusing and reclaiming.”

  • Turning toward involves directly asking patients to describe their experience of suffering through questions such as “What’s the worst part of this for you?” and then attentively listening to and closely observing the patients’ responses. By recognizing that diagnosis and treatment can address only a portion of human suffering, physicians can become more emotionally available and engaged, expressing comfort and caring through an authentically compassionate bedside manner.
  • Refocusing and reclaiming involves helping patients come to terms with illness and reconnecting with what is important and meaningful in their lives. By helping patients deal with the pain, difficult choices and uncertainty often inherent in illness and associated medical care, clinicians can guide patients toward greater equanimity and acceptance. In addition, by confronting their own discomfort with suffering in a head-on manner, the authors assert, physicians can find a deeper sense of purpose and meaning in their own work.

Taken together, this body of research suggests that, when it comes to medicine, softness and strength — that is, emotional and intellectual acumen — may accurately be described as two sides of the same currency, obtaining benefits for physician and patient alike.